COMMUNITY DEVELOPMENT DEPARTMENT
CITY OF PASADENA, TEXAS
Final Wage Compliance Report
10/2020
SUBMIT ONE FORM FOR EACH CONSTRUCTION CONTRACT OVER $2,000
Subrecipient: IDIS Number: Ordinance Number:
Construction Completion Date: Contract Amount:
Prime Contractor:
Sub-Contractor(s):
Were any workers paid less than the Davis-Bacon rates that applied to this project? Yes No
If YES, fill in the box below.
Were any workers paid less than the correct overtime payments? Yes No
If YES, liquidated damages at the rate of $25 for each calendar day for each worker must be calculated and the contractor
notified of his liability. Provide information concerning the nature of the overtime violations. This should include:
Names of Affected
Employees
Amount of
Davis-
Bacon
Restitution
Paid
Amount of
CWHSSA
(overtime)
Restitution
Paid
Davis-
Bacon Wage
Violation?
(Yes or No)
CWHSSA
(overtime)
Violation?
(Yes or No)
*If additional space needed, please attach separate page
Attach copies of all correspondence relative to any Liquidated Damages (i.e. letter from subrecipient to company
assessing liquidated damages, copies of payrolls showing discrepancies, copies of evidence of back wages paid like
canceled checks or other acceptable evidence, and copy of waiver request letter).
Did the Contractor seek a reduction or waiver of the liquidated damages? Yes No
If YES, was the request approved? Yes, reduction Yes, waiver
Total amount of Liquidated Damages Paid: _____________________________________
Number of Workers owed restitution but unfound: _____________________________________
Total restitution owed to unfound workers: _____________________________________
Submitted by:
Labor Standards Officer: ______________________________________ Date: __________________
